-
assessment consideration
- differential diagnosis-determining what the disease is not, could be coexistence of several disorders
- early intervention=treatment should begin as early as possible
- examination of all subsystmes
- primary goal is to maximized the effectiveness, efficiency and natrualness of communication
-
examples of standardized tests for dysarthria
- frenchay
- dysarthria profile
-
most tests will include the following assessment areas:
- oral mechanics exam= overall assessment of structure and function of the speech structures
- -observation of oral structures at rest
- -isolated oral movements of these oral structures (ie purse lips etc)
- -diadochokinesis=or alternating oral non speech motion (open and close mouth rapidly, protrude retract tongue etc)
- reflexes=ask them about the dif reflexes (ie gag)
- speech assesment= -respiratory=observe chest excursions at rest, observe breathing during speech
- -laryngeal=time, ptich, volume
- articulatory/resonance=
- -alternating speech motion using diadochodinetic tasks puh-tuh-kuh
-
what other areas are good to observe
- vision
- dentition
- mood
- posture
-
tests used for apraxia
- 1. includes section to assess presence of limb apraxia (arm goes up instead of down)
- 2. diadochokinesis
- 3. repeating words of increasing length
- 4. oral limb apraxia
- 5. say same 10 words 3x in a row
- 6. production of the grandfather passage
-
treatment of neuromotor speech disoders
apraxia
- orderly progression of treatment tasks
- -sound hierarchy
- -task hierarchy
- intensive and frequent drill
- gradual removal of clinician cues
- program must be individualized to the patient or speaking tasks
- should be relevant to clients' everyday needs
-
treatment of neuromotor speech disoders
dysarthria
- medical=
- -pharmacologic=manage disorder with medications that treat symptims or illness
- -surgical=manage disorder through surgical devices
- behavioral=strengthen the muscles
- -drill strength exercises fro all subsystems involved
- -use aac symbols. compensatory strategies
- -promote self-monitoring to enhance patient independence
- -educate family
-
examples of behavioral therapy for the speech subsystems
resp
- respiration=increase resp support
- -blowing water through a straw
- -coach them to begin speech by taking a deep inhalation and pushing
- -max vowel prolongation
- -increadsing the length of phrases and sentences by focusing on breath groups
- -postural adjustments
-
examples of behavioral therapy for the speech subsystems
phonation/resonanace
- stimulate velopharyngeal muscles
- provide feedback to address nasla flow during speech
- alternating oral/nasal syllables
- pitch exercises
- bearing down
- easy onsets
-
examples of behavioral therapy for the speech subsystems
articulation
- strength training of the articulators
- stretch training for those with spasticity
- target rate
- precision of consonants
-
what is cognition and language
- cog=formulating an idea, comprehension, problem solving, memory and perception
- lang-sensory, motor, and cognitive
- comprehension=auditory or visual
- production=motor systems. oral and manual
- reading=visual or tactile
- writing=motor or visual
- non verbal gestures
-
tbi
- chi or ohi
- age most affected is 35 and below
- cause=head trauma by penetration or forceful impact
- primary damage=
- -focal contusion
- -axonal shearing in which the axon is cut or myelin sheath is damaged, cause by skull breaking
- secondary causes=
- -infection
- -hypoxia
- -edema (brain swelling)
- -infarction (tissue death)
- -hematomas (focal areas of blood or torn blood vessels)
- we see cognitive as well as perceptual damage with tbi
-
cva
- cerebral vascular stroke (attack, accident)
- most common cause of focal bd
- -blockage
- -break
- -specifically in blood vessels-brain misses out on o2 and will eventually die resulting in damage of neural tissues
- usually people 65 and older
- -aa more likely to suffer because of ses, lack of healthcare etc
- risk factors include
- -controlable and uncontrolable
-
cva
uncontrollable and controlable
- cont
- -diet
- -smoking
- -exercise
- -alcohol
- -hypertension
- uncont
- -age
- -family history
- -sex
- -ethnicity
-
cva
mechanisms of
- vascular system (circle of willis)
- nervous system
- limbic system
-
dementia
- chronic progressive deterioration of intellect, personality, and memory and...
- -communication processes
- =resulting from cns, dysfunction
- =7 mil people in the us
- =strongly associated with age and typically live with it for a decade
- -symtoms
- =gradual onset, difficult to diagnosis
- =personality changes
- =overal cognitive impairment
- =motor difficulties
- =loss of lang skills
- =progressive memory deficits
|
|